MICROINVASIVE CARCINOMA OF THE UTERINE CERVIX - HISTOLOGICAL-FINDINGSON CONE SPECIMENS RELATED TO RESIDUAL NEOPLASIA ON HYSTERECTOMY

The treatment of cervical microinvasive carcinoma is controversial. Hy sterectomy is performed in almost all cases, associated or not with mo re radical procedures. Currently, there is a tendency to adopt conserv ative management to treat patients with early invasion, as long as it can be assured that the whole lesion has been removed. The aim of this study was to establish which histological information should be obtai ned from the cones that would give the best possible assurance of abse nce of residual neoplasia in the patient. This was done by comparing c one and hysterectomy specimens from each patient. One hundred sixty-th ree cases, treated from 1967 to 1994, underwent simple or radical hyst erectomy following tone biopsy. We evaluated the following histologica l features in the cones: (i) invasion depth, (ii) lateral extension of the lesion, (iii) unifocal or extensive lesion, (iv) vascular invasio n, (v) morphological signs of HPV infection, and (vi) free or involved cone surgical margins. Residual neoplasia in the histerectomy was mor e frequent when the margins of the cone were involved by atypical epit helium, and in cases with signs of HPV infection. However, according t o statistical analysis, these two variables were not mutually independ ent, and the only important parameter to predict residual neoplasia in the hysterectomy specimens was involved surgical margins in the cone. (C) 1997 Academic Press.